Gout is a systemic disorder (that is, one potentially affecting the entire body), marked by elevated blood levels of uric acid, one of the body's waste products. This buildup in the blood can be caused by over production of uric acid, impaired excretion of it in the urine, or sometimes a combination of both. As it accumulates, uric acid may form crystals in the joints. Thus, gout is often first recognized by inflammation of a single joint. The immune system typically reacts to these crystals as if they were foreign invaders and releases substances that produce inflammation. The affected joint becomes swollen, red, warm, and severely painful. Often the first episode of gout affects the base of the big toe (this joint is eventually affected in 90 percent of patients).

Although symptoms gradually subside within a week, subsequent attacks are likely. These generally strike with no warning, occur with increasing frequency, and affect a number of joints, including the knees, elbows, wrists, and those of the hands and feet. Significantly elevated uric acid levels in the blood, if untreated, may result in kidney stones or deposition of uric acid in the kidneys, possibly causing kidney failure. About 90 percent of those affected with gout are adult men. In women, the disorder usually strikes after menopause.

Symptoms of Gout

• Sudden and severe pain in a joint, often the big toe.
• Swelling and redness around the affected joint.
• Fever (in some cases).
• Kidney stone symptoms, which include intermittent pain, sometimes excruciating, beginning in the lower back and traveling to the groin; interruption of the urine stream; inability to urinate except in certain positions; and a frequent urge to urinate but with only small amounts of urine passed.

What Causes Gout?